Qureshi Muhammad A, Robbie Scott J, Tabernero Juan, Artal Pablo
From the London Eye Hospital (Qureshi), London Eye Hospital Pharma (Qureshi, Robbie), London, United Kingdom; Laboratorio de Optica (Tabernero, Artal), Universidad de Murcia, Murcia, Spain.
From the London Eye Hospital (Qureshi), London Eye Hospital Pharma (Qureshi, Robbie), London, United Kingdom; Laboratorio de Optica (Tabernero, Artal), Universidad de Murcia, Murcia, Spain.
J Cataract Refract Surg. 2015 Oct;41(10):2125-35. doi: 10.1016/j.jcrs.2015.03.021.
To assess the feasibility of a new injectable telescopic intraocular lens (IOL).
London Eye Hospital, London, United Kingdom.
Prospective interventional pilot study.
Eyes with bilateral, intermediate, or advanced dry age-related macular degeneration (AMD); preoperative decimal corrected distance visual acuity (CDVA) of 0.25 or less; and improvement with extraocular simulation of the intervention had implantation of 2 IOLs designed for use together in a Galilean telescope configuration (iolAMD). Patients were followed for 4 months. Safety was assessed by monitoring visual acuity, intraocular pressure, specular microscopy, and anterior segment and macular optical coherence tomographies. Fixation stability and macular sensitivity were determined using microperimetry in some eyes.
There were no significant intraoperative or postoperative complications. In 1 eye, an anterior sulcus IOL was replaced; there were no sequelae. The mean endothelial cell density was reduced by 18%. The mean decimal CDVA improved from 0.12 preoperatively to 0.20 at 4 months, a 67% gain. The mean change in spherical equivalent after implantation was -1.5 diopters (D) with 0.5 D of induced astigmatism. Microperimetric testing indicated a magnification effect and a deviation of the retinal image by up to 5 degrees, with improved fixation stability.
This injectable intraocular miniature telescope appears safe in the short to medium term and capable of improving visual function. No significant issues were encountered regarding candidate eye selection or patient retention and cooperation. Further work is needed to evaluate the safety and efficacy of the device, particularly with respect to daily-living activities and the range of indications.
Dr. Qureshi has a financial interest in London Eye Hospital Pharma. No other author has a financial or proprietary interest in any material or method mentioned.
评估新型可注射式伸缩式人工晶状体(IOL)的可行性。
英国伦敦伦敦眼医院。
前瞻性干预性试点研究。
患有双侧、中度或晚期干性年龄相关性黄斑变性(AMD);术前小数矫正远视力(CDVA)为0.25或更低;且通过眼外模拟干预有改善的患者,植入了2个设计用于以伽利略望远镜配置一起使用的IOL(iolAMD)。对患者进行了4个月的随访。通过监测视力、眼压、镜面显微镜检查以及前段和黄斑光学相干断层扫描来评估安全性。在一些眼中使用微视野计确定注视稳定性和黄斑敏感度。
术中或术后均无显著并发症。1只眼中更换了前房沟IOL;无后遗症。平均内皮细胞密度降低了18%。平均小数CDVA从术前的0.12提高到4个月时的0.20,提高了67%。植入后球镜等效度的平均变化为-1.5屈光度(D),诱导散光为0.5 D。微视野计测试显示有放大效应,视网膜图像偏差可达5度,注视稳定性有所改善。
这种可注射式眼内微型望远镜在短期至中期似乎是安全的,并且能够改善视觉功能。在候选眼选择、患者留存率和合作方面未遇到重大问题。需要进一步开展工作来评估该装置的安全性和有效性,特别是在日常生活活动和适应证范围方面。
库雷希医生在伦敦眼医院制药公司有经济利益。其他作者对文中提及的任何材料或方法均无经济或专利利益。